International studies have reported that quality in patient care and safety, as well as the personal well-being of resident doctors, may suffer a detriment if a highly demanding or hostile clinical training environment is present. The objective of the Professionalism and Wellbeing Program for Medical Residents implemented by a university in northern Mexico is to integrate strategies for the development of wellbeing as a professional competence, and to contribute to strengthening clinical training environments, with the intention of improving personal selfcare, wellbeing, and patient care. The program was implemented with the 290 medical residents of the 17 specialty programs from March 2019 and, additionally, an hybrid model was implemented due to the COVID-19 pandemic from April 2020 to date. In February 2019 and 2020, medical residents participated in the induction sessions of the Professionalism and Wellbeing Program and at least in 3 sessions through the semester, in 2019 face-to-face and in 2020 virtually. The chiefs and co-chiefs of residents were trained in a Workshop so they could help other residents in adverse situations. Among the virtual strategies, we implemented an online website, an electronic form for residents´ wellbeing and mentoring follow-up, individual virtual counseling and Balint groups in Zoom. From April 2020 to February 2021, 220 residents registered online their wellbeing follow-up. The topics of greatest interest for discussion selected by the participants (n= 51) in the Balint group sessions were: emotional well-being in health professionals (94.1%) and burnout syndrome (94.1%). These initiatives aim to strengthen the training processes of education, professionalism, and humanism, with the residents as an expression of the social responsibility of the profession to contribute to selfcare, wellbeing, and patient’s care. Keywords: higher education, educational innovation, hybrid postgraduate medical education, residents’ wellbeing, COVID-19
The pandemic has posed many challenges for the academic continuity of clinical training. The social responsibility of universities and the professionalism of physicians inspired residents on taking the leadership in the front line of COVID-19. Their direct involvement in patient care required the establishment of protocols to offer mentoring and support services for self-care and mental health strategies to prevent burnout. The objective of this study was to describe the design and implementation of a comprehensive strategy to transform the Multicentric Program of postgraduate medical education in northern Mexico to continue academic and clinical training activities amid the pandemic. The participants in this study include six training centers which represent 290 physicians in 17 medical specialties programs. The results of the designed strategy focus on three specific activities: 1) offering formal curricular elements through online platforms and mobile devices, 2) adaptative clinical training for the residents participating directly in SARS-Cov2 patient care, and 3) specific training on COVID-19 for all participants on patient safety protocols and use of protective equipment. All 17 programs achieved academic continuity by the use of digital platforms. The protection and safety of the educational community were privileged with the purpose of training by providing residents specific safety training on COVID-19, personal protection equipment, periodical PCR testing and by the vaccination strategy. The responsibility and responsiveness of educational institutions to address the challenges to continue the clinical training during the health crisis will significantly affect the educational results and preparedness of the next generation of health professionals. The commitment of universities should be beyond academic continuity or sharing content online, it should address as well self-care and wellbeing strategies that could provide graduates with the skills that are essential to thrive in the current pandemic. Keywords: higher education, educational innovation, postgraduate medical education, residents’ education, COVID-19
The SARS-COV2 health contingency and the cessation of face-to-face activities has motivated multiple educational innovations for distance teaching. Medical schools are particularly defied because of the need for clinical training, however simulation offers opportunities to achieve continuity. A clinical simulation exercise was redesigned and transformed to an online synchronic simulation via Zoom. The participating groups of medical students (n=53) were in the Bioethics and Clinical Bioethics courses, adjunct to their Pediatrics and Obstetrics and Gynecology (ObGyn) clerkships in June 2020. Two simulated clinical cases were performed via Zoom, followed by a debriefing session. Later, an online survey was applied to the participants to know their perception and experience with this new version, considering they had experienced the original face-toface simulation on the alternate clerkship the prior trimester. A mixed method approach was used to analyze the responses. The results showed that the virtual format was very effective, 72% considered it very similar to the original version. The exercise revealed high emotional commitment, allowing students to develop their socio-emotional skills. Student reactions were categorized and coded as emotions triggered by a) their performance as professionals, b) those related directly to the patient’s emotions and situation, which showed significant gender differences, and c) students' anxiety related to the academic exercise itself, the least found. The fact that the clinical component was restructured due to the remote format may have helped in focusing on the preponderance of emotional, communication and relational aspects of the patient-doctor relationship. Also, most students identified the exercise was meaningful in approaching bioethics contents, including end-of-life decisions in patient care, and informed consent. In conclusion, the online clinical simulation activity proved effective in integrating professionalism outcomes that encompass ethical knowledge, skills and attitudes that prepare medical students for their professional role, along with the debriefing reinforcing insightful learning integration. Keywords: educational innovation, higher education, clinical simulation, humanism, ethics
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